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Overhaul for GPs' use of warfarin

GP procedures for use of warfarin are to be overhauled following a new report warning patients are not being adequately protected.

By Daniel Cressey

The National Patient Safety Agency found GP training and auditing were insufficient, there was too much potentially dangerous co-prescribing and too few checks were made when issuing repeat scripts.

Its report analysed Medical Defence Union data showing rising cases against GPs for problems arising during anticoagulation treatment (see chart).

The agency has issued a series of draft recommendations for improving anticoagulation services, which will be circulated in final form to primary care organisations in England and Wales later in the year.

It wants to see more regular monitoring of patients on drugs such as NSAIDs which can interact with warfarin, more stringent checks before issuing repeat scripts and regular audit of safety indicators.

PCO compliance with the final recommendations will be monitored by the Healthcare Commission.

Professor David Cousins, head of the National Patient Safety Agency's safe medication practice team, said: 'The NPSA continues to have dozens of reports each month [about anticoagulants]. What it's indicating is that the anticoagulant system needs to be enhanced and improved. It's a long time since anticoagulation got any airtime so it's a bit overdue.'

Professor Cousins added: 'The risks are all included in the report ­ all we're doing is addressing the risks we've identified. I don't want GPs to feel this is being steamrollered through. We want their opinions.'

The draft recommendations will be out to consultation until March.

Dr Nick Norwell, MDU medicolegal adviser, said: 'Warfarin is a hugely important drug ­ first of all because of the dangers, and second, because of the amount it is used. Monitoring, keeping control, is the secret to prevention of catastrophes.'

The consultation is online (see right)

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